EP1971384B1 - Endotracheal tube - Google Patents
Endotracheal tube Download PDFInfo
- Publication number
- EP1971384B1 EP1971384B1 EP07706942.5A EP07706942A EP1971384B1 EP 1971384 B1 EP1971384 B1 EP 1971384B1 EP 07706942 A EP07706942 A EP 07706942A EP 1971384 B1 EP1971384 B1 EP 1971384B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- endotracheal tube
- tube
- patient
- cross
- endoscope
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Not-in-force
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0402—Special features for tracheal tubes not otherwise provided for
- A61M16/0415—Special features for tracheal tubes not otherwise provided for with access means to the stomach
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0486—Multi-lumen tracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
- A61M16/049—Mouthpieces
- A61M16/0493—Mouthpieces with means for protecting the tube from damage caused by the patient's teeth, e.g. bite block
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0434—Cuffs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0461—Nasoendotracheal tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0463—Tracheal tubes combined with suction tubes, catheters or the like; Outside connections
Definitions
- the present invention relates to an endotracheal tube.
- Laparoscopy is known in which, instead of making a wide incision in the abdominal wall, a plurality of openings are formed in the abdominal wall and manual procedures are performed by inserting a rigid laparoscope, forceps, and a surgical knife, into the separate openings, in the case in which medical procedures (including observation, procedure, or the like; the same goes in the following) are performed on internal organs of a human body.
- Laparoscopy has an advantage in that early recovery of a patient can be expected since it requires only forming small openings in the abdomen.
- procedure of an organ is performed by using: a treatment tool which passes through the endoscope; or a treatment tool which is inserted into the abdominal cavity through another opening formed in the stomach, or which is inserted from the anus into the abdominal cavity through an opening formed in the lower digestive tract.
- a treatment tool which passes through the endoscope or a treatment tool which is inserted into the abdominal cavity through another opening formed in the stomach, or which is inserted from the anus into the abdominal cavity through an opening formed in the lower digestive tract.
- ES 2 051 241 A1 discloses an endotracheal anaesthetic tube for laryngeal microsurgery.
- the anaesthetic tube is of semicircular or trapezoidal section.
- US 6 443 156 B1 discloses a separable double lumen endotracheal tube having a first lumen and a second lumen which are removably affixed together. Either lumen of the double lumen endotracheal tube can function alone for positive pressure ventilation.
- An endotracheal tube according to claim 1 is provided.
- FIG. 1 shows an endotracheal tube of an example useful for understanding the invention.
- This endotracheal tube is used by installing it into a patient through the mouth.
- the endotracheal tube 1 is used together with an over-tube 2 (one example of a device having an insertion section to be inserted into a body of the patient) which is used for guiding an endoscope through the mouth, and is used by being installed into the patient.
- this endotracheal tube 1 is used together with the endoscope (one example of another device) which is used through the mouth, instead of using the over-tube 2; and the endotracheal tube 1 is used by being installed into the patient.
- the endotracheal tube 1 includes a tube main body 3; a connecting portion 4 which is attached to a proximal end of the tube main body 3, and is to be connected to a respirator; and an anchoring portion 5 which anchors the endotracheal tube 1 to a predetermined location in a body of a patient PT.
- the anchoring portion 5 includes a cuff balloon 5a, and a cuff tube 5b for supplying air into the cuff balloon 5a.
- the tube main body 3 is made from a material such as rubber, which is flexible and is harmless to the human body.
- a proximal end 3 A and a distal end 3B of the tube main body 3 has a circular cross-sectional shape.
- a flat portion 6 having a flat shape is formed in a middle portion of the tube main body 3.
- a cross-sectional face of the flat portion 6 explained herein is not limited to a crescent-shape as shown in FIG. 2 , and may be of other cross-sectional shapes such as a rectangular shape, a semi-circular shape, an elliptical shape, or the like. That is, the flat portion 6 may be one having a cross-sectional face which is not a full-circular shape and of which the longer and shorter area axes can be specified.
- a portion of the tube main body 3 where the flat portion 6 is formed is a portion which is to overlap with the over-tube 2 for guiding the endoscope or with the endoscope to be inserted into the patient PT through the mouth, when the endotracheal tube 1 is installed into the patient PT through the mouth. That is, when viewed from the patient side, the portion of the tube main body 3 where the flat portion 6 is formed, is a portion to be located at a position from the larynx 7 to the musculus arytenoideus transversus 8.
- the flat portion 6 is formed within a range approximately of 50 mm to 150 mm, from the distal end towards the proximal end side of the endotracheal tube 1.
- an outer surface portion 6a of the flat portion 6, formed along the length in the cross-sectional face will contact the endoscope or the over-tube 2 as shown in FIG. 2 .
- a cross-sectional area of the flat portion 6 is set to be substantially equal to a cross-sectional area of a circular cross-sectional portion formed on the side of the proximal end portion or the distal end portion of the endotracheal tube 1.
- an external diameter (also an internal diameter) of the flat portion 6 is set to be smaller than an external diameter (an internal diameter) of the proximal end 3A or the distal end 3B.
- the medical procedure may be one of a variety of procedures such as suturing, observation, incision, inoculation of cells, extraction of internal organs, anastomosis between the lumen internal organs, and the like.
- the patient is anesthetized.
- the head of the patient PT is directed downwards and is fixed such that each of the trachea 9 and an esophagus 10 becomes substantially straight.
- a passage from the larynx 7 to the musculus arytenoideus transversus 8 of the patient PT can be made substantially linear; and furthermore, an interference portion between the over-tube 2 to be installed later and the endotracheal tube 1 can be shortened.
- the endotracheal tube 1 is inserted through the oral cavity 12 of the patient PT using a laryngoscope 11.
- the endotracheal tube 1 is anchored by the anchoring member 5. That is, the endotracheal tube 1 is anchored by supplying air into the cuff balloons 5a through the cuff tube 5b and thereby expanding the cuff balloons 5a.
- the flat portion 6 of the endotracheal tube 1 is located within a region between the larynx 7 and the musculus arytenoideus transversus 8 of the patient PT.
- the connecting portion 4 of the anchored endotracheal tube 1 is connected to the respirator; thereby, supplying necessary air, oxidant gas, or anesthesia gas into the lungs of the patient PT, and artificially controlling the breathing of the patient PT.
- the distal end of the over-tube 2 (a device used for performing medical procedures the same as the endoscope) is inserted through the oral cavity 12 of the patient PT until the distal end thereof reaches the inside of the esophagus 10.
- the endoscope is used together, so as to be inserted into the body through the inside of the over-tube.
- the endotracheal tube 1 anchored in advance and the over-tube 2 to be newly inserted will interfere within a region between the larynx 7 and the musculus arytenoideus transversus 8 of the patient PT; however, the endotracheal tube 1 is provided with the flat portion 6, and the outer surface 6a of the flat portion 6 along the length contacts the over-tube 2.
- the shorter diameter of the flat portion 6 is set to be smaller than the external diameter of the proximal end portion 3A or the distal end portion 3B. Therefore, as shown in FIG.
- the width L of an overlapped portion between the flat portion 6 of the endotracheal tube 1 and the over-tube (or an inserting device such as an endoscope) can be comparatively smaller (i.e., the width of a portion overlapped with an inserting device can be smaller compared to the case in which a substantially circular-shaped endotracheal tube having no flat portion 6 is used).
- the burden on the larynx 7 of the patient PT can be decreased.
- the cross-sectional area of the flat portion 6 is set to be substantially equal to that of a circular cross-sectional portion at the distal end portion or the proximal end portion of the endotracheal tube, there is no possibility of causing a problem in which the air-supply amount through the endotracheal tube is decreased by the formed flat portion 6.
- the endotracheal tube and the over-tube, each having a circular-cross section will be overlapped with each other within a range from the larynx 7 to the musculus arytenoideus transversus 8 of the patient PT (i.e., a portion where the digestive organ system and the respiratory organ system intersect each other); thereby, greatly increasing the width of the overlapped portion.
- the burden on the larynx of the patient greatly increases.
- an insufflate needle is embedded in the abdomen of the patient PT, and carbonic acid gas or the like is supplied into the abdominal cavity; thereby expanding the abdominal cavity.
- the reason for expanding the abdominal cavity is to secure space for performing medical procedures in the abdominal cavity.
- carbonic acid gas may be supplied into the abdominal cavity using a channel within the endoscope instead of using the insufflate needle.
- the diaphragm of the patient PT is pressed while in the insufflate condition. Especially, in the case in which the amount of anesthesia is large, natural breathing becomes hard; therefore, breathing of the patient is controlled by using the endotracheal tube 1.
- an insertion portion of the endoscope is advanced into the abdominal cavity through an opening formed by the incision of the stomach wall, while replacing the over-tube 2 and the endoscope in accordance with necessity; and thereafter, the predetermined procedure is performed in the abdominal cavity using the endoscope.
- the reason for replacing the over-tube 2 in accordance with necessity is that the required cleanliness is different between the inside of the stomach and the inside of the abdominal cavity.
- the reason for replacing the endoscope is, the same as for the over-tube 2, that the required cleanliness is different between the inside of the stomach and the inside of the abdominal cavity; and the most suitable device for the procedure at that time needs to be used.
- the devices such as the over-tube or the endoscope may not need to be replaced.
- the distal end of the endoscope When the necessary procedure inside the abdominal cavity is completed, the distal end of the endoscope is retracted to the inside of the stomach wall; and the opening portion is sutured by a treatment tool for suturing.
- a suture is to close a communication between the inside of the lumen internal organs and the inside of the abdominal cavity; and closing a communication between the inside of the luminal Internal organs and the inside of the abdominal cavity using a way such as anastomosis, is also included in the category of suturing.
- the endoscope and the over-tube 2 are each removed from the patient PT; and furthermore the endotracheal tube 1 is removed from the patient PT when breathing control of the patient becomes unnecessary.
- the flat portion 6 is formed at a portion at which the endotracheal tube 1 and the over-tube overlap with each other in the larynx of the patient PT; however, as shown in FIG. 3 , a reinforcing member such as a rib 6b which suppresses compression in the shorter direction of the flat portion 6 may be provided at substantially the middle portion along the length of an inner surface of the flat portion 6. In this case, collapsing of the flat portion 6 can be suppressed by the rib 6b even when the over-tube 2, the larynx, or the like applies an external force for compressing the endotracheal tube 1.
- a plurality of ribs 6b may be provided.
- a rod-shaped member such as a wire for suppressing compression in the shorter axis of the flat portion may be provided as a reinforcing member so as to pass through at least the flat portion instead of the rib 6b.
- FIG. 6 shows a first embodiment of an endotracheal tube.
- this endotracheal tube 20 is also used by being installed into a patient through the mouth.
- This endotracheal tube 20 has special features in that a portion of a tube main body 21, overlapping with the endoscope or the over-tube 2 to be inserted into the patient PT through the mouth when it is installed into the patient (i.e., an interfering portion) is formed into a plurality of (two in FIG. 7 ) branching passages 22; and the above-mentioned over-tube 2 passes between the branching passages 22.
- Each of these branching passages 22 is also formed in a flat shape. As shown in FIG. 7 , the branching portions 22 formed in the flat shape are formed such that their longitudinal directions M in a cross section are parallel with each other.
- a total cross-sectional area of the pluralities of branching passages 22 is set to be substantially equal to a cross-sectional area of a circular cross-sectional portion formed on the side of the proximal end portion 2OA or the distal end portion of the endotracheal tube 20.
- the total width of the branching portions 22 in the shorter direction which are substantially orthogonal to the longitudinal directions M in a cross section set to be shorter than an external diameter of the endotracheal tube on the distal end side or the proximal end side.
- the width L of an overlapping portion between the over-tube 2 and the branching portions 22 of the endotracheal tube 1 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient while securing the necessary amount of air supplied from the endotracheal tube 20.
- a half way portion of a tube main body 21 is divided into a plurality of branching passages 22, compression of tissue around the larynx of the patient can be decreased when inserting the endoscope or the over-tube. At this point, the burden on the larynx of the patient can be further decreased.
- FIG. 6 and FIG. 7 an explanation is given for an example in which two branching passages 22 are formed; however, there is no limitation to this, and the number of the branching passages 22 may be equal to or more than three. Furthermore, as same as the first example, a reinforcing member for suppressing compression in the shorter axis of the branching passages 22 may be provided.
- FIG. 9 shows an endotracheal tube of a second embodiment.
- this endotracheal tube 30 is also used by being installed into a patient through the mouth.
- a special feature of this endotracheal tube 30 is that a mouthpiece 31 is attached to a proximal end side thereof.
- An insertion hole 32 for inserting the endoscope or the over-tube 2 is formed at the middle portion of the mouthpiece 31.
- a space 33 is formed on the outer side of the insertion hole 32 of the mouthpiece 31.
- the space 33 communicates with a connecting portion 35 provided on a frontal plate portion 34 of the mouthpiece 31; and branching passages 37 inserted into the bottom plate portion 36 of the mouthpiece 31.
- the total width of the branching portions 37 in the shorter direction which are substantially orthogonal to the longitudinal directions M in a cross section set to be shorter than an external diameter of the endotracheal tube on the distal end side or the proximal end side.
- a reference symbol 39 denotes a string for fixing the mouthpiece 31 onto the mouth of the patient; and it is brought to the back of the head of the patient and is bound.
- branching passages 37 of a tube main body 38 are formed so as to be separated within a region where a tube main body 31 overlaps with the endoscope or the over-tube 2 to be inserted into the patient PT through the mouth when the endotracheal tube 30 is installed (i.e., an interfering portion). Also in this endotracheal tube 30, as shown in FIG.
- the width L of an overlapping portion between the over-tube 2 and the blanching portions 37 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply.
- a reinforcing member for suppressing compression in the shorter direction of the branching passages 37 may be provided.
- FIG. 13 shows an endotracheal tube of a third embodiment.
- This endotracheal tube 40 is also used by being installed into a patient through a nasal cavity.
- This endotracheal tube 40 has special features in that a portion overlapping with the endoscope or the over-tube 2 to be inserted into the patient through the mouth when it is installed into the patient (i.e., an interfering portion) is formed into a plurality of (two in FIG. 13 ) branching passages 42; and the branching passages 42 are formed in a semicircular cross-sectional shape of which flat portions 42a thereof face each other.
- the point that the endoscope or the over-tube 2 is inserted between these branching passages 22 is the same as in the first embodiment and the second embodiment.
- the total cross-sectional area of two branching passages 42 is set to be substantially equal to the cross-sectional area of a circular cross-sectional portion on the proximal end side or the distal end side.
- branching passages 42 into the semi-circular cross-sectional shape is to let them pass through the nose of the patient when installing the endotracheal tube 40 into the patient. That is, a passage of the nasopharynx is formed in a circular cross-sectional shape. In order to easily pass through this portion, the two branching passages 42 form a just circular cross-sectional shape when they are combined with each other.
- a shape of each branching passage 42 is set such that a dimension L2 in the cross-sectional longitudinal direction when the two branching passages 42 are combined with each other is larger than a total dimension L1 in the cross-sectional shorter direction.
- the reason for selecting a flat shape instead of a full-circular shape for the cross-sectional shape of the combined two branching passages 42 is in consideration of reducing the maximum external diameter of the portion overlapping with the over-tube 2 or the endoscope to be inserted into the patient through the mouth together with the branching passages 42.
- the insertion-ability through the nose is secured by setting the dimension L2 slightly larger than the dimension L1.
- FIG 16 is for explaining the state in which the endotracheal tube 40 is installed into the patient PT through the nasal cavity.
- forceps inserted through the oral cavity 12 may be used in accordance with necessity.
- the over-tube 2 is inserted through the oral cavity of the patient PT after inserting the endotracheal tube 40 through the nose of the patient PT and anchoring it thereto. At this time, as shown in FIG. 15 and FIG. 17 , it is inserted through an opening made between the two branching passages 42.
- the endotracheal tube 40 is made from a predetermined flexible material; and a state in which combining of the two branching passages 42 is secured by the elasticity thereof, while no external force is applied.
- insertion of the endoscope or the over-tube 2 through the two branching passages 42 can be done by opening these branching passages 42 using predetermined tools such as forceps.
- the width of an overlapping portion between the branching passages 42 and the over-tube 2 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply.
- a length of a portion interfering with devices such as the endoscope or the over-tube can be shorter. That is, comparing to the case in which the endotracheal tube is inserted through the mouth, the burden on the patient can be further reduced since a length of the portion overlapping with devices such as the over-tube or the endoscope to be inserted through the mouth can be shorter. Furthermore, there is an advantage in that it is unlikely to be removed while inserting and removing the endoscope or the like since there is no interference in the oral cavity of the patient.
- FIG. 18 shows a tool used for medical procedures through the natural openings according to an example useful for understanding the invention.
- This tool 50 is constituted by an endotracheal tube 51 and an over-tube 52.
- the endotracheal tube 51 is used by being installed into the patient through the mouth or through the nasal cavity.
- the over-tube 52 is used by being installed into the patient through the mouth.
- An endotracheal-tube accommodating portion 53 having a non-circular-cross-sectional shape and capable of face-contacting with the endotracheal tube 51 is formed at a portion of the over-tube 52, overlapping with the endotracheal tube 51 installed into the patient while the over-tube 52 is installed into the patient.
- the endotracheal-tube accommodating portion 53 has, when it is seen in a cross-sectional view, a cross-sectional face in which one part of a circle is removed so as to be flattened.
- a semi-circular cross-sectional portion 54 is formed at a position corresponding to the above-mentioned endotracheal-tube accommodating portion 53 of the endotracheal tube 51.
- the semi-circular cross-sectional portion 54 has a shape corresponding to a removed portion where the above-mentioned endotracheal-tube accommodating portion 53 is formed. That is, when a flat portion 53a of the endotracheal-tube accommodating portion 53 and a flat portion 54a of the semi-circular cross-sectional portion 54 overlap with each other, a circular cross-sectional shape is formed as shown in FIG. 21 .
- an overlapping portion between the endotracheal tube 51 and the over-tube 52 can be comparatively small (i.e., the width of the combined endotracheal-tube accommodating portion 53 and semi-circular cross-sectional portion 54 can be comparatively small); therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply.
- combinations of the endotracheal tube 51 and the over-tube 52 are not limited to that disclosed in FIG. 18 and FIG. 19 ; and as shown in FIG.
- the endotracheal-tube accommodating section 53 may be formed by a groove 55 which accommodates a part of the endotracheal tube 51.
- a cross-sectional shape of the over-tube has a different shape only at a portion interfering with the endotracheal tube.
- it may be arranged such that the entire range from a distal end to a proximal end of the insertion section of the over-tube has a different shape.
- the present invention is not limited to the above-mentioned embodiments.
- the hollow organ in which the opening is to be formed is not limited to the stomach, and it may be formed in any internal organs such as the esophagus or the duodenum, which can be approached through the mouth.
- manual procedure in which medical procedures are performed in the hollow organ without approaching the inside of the abdominal cavity may be included. Additions, omissions, substitutions, and other modifications can be made without departing from the scope of the present invention.
- the invention is not to be considered as being limited by the foregoing description, and is only limited by the scope of the appended claims.
- burden on a patient can be decreased since an overlapping portion of an endotracheal tube, where overlaps with a device is made to be a flat shape to reduce the width of the overlapping portion between an endotracheal tube and the device.
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- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Emergency Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Otolaryngology (AREA)
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Description
- The present invention relates to an endotracheal tube.
- Priority is claimed on
U.S. Patent Application No. 11/331,977, filed January 13, 2006 - Laparoscopy is known in which, instead of making a wide incision in the abdominal wall, a plurality of openings are formed in the abdominal wall and manual procedures are performed by inserting a rigid laparoscope, forceps, and a surgical knife, into the separate openings, in the case in which medical procedures (including observation, procedure, or the like; the same goes in the following) are performed on internal organs of a human body. Laparoscopy has an advantage in that early recovery of a patient can be expected since it requires only forming small openings in the abdomen.
- However, in recent years, as for manual procedures which further reduce the burden on the patient, performing manual procedures by inserting a flexible endoscope through natural openings such as the mouth, the nose, or the anus, of the patient has been proposed. One example of such a medical procedure is disclosed in
US Patent No. 5,458,131 . This medical procedure will be explained. A flexible endoscope is inserted through the mouth of a patient; and the endoscope is fed into the abdominal cavity through an opening formed in the stomach wall. Observation of the abdominal cavity is performed by observation device provided on a distal end of the endoscope. - Furthermore, procedure of an organ is performed by using: a treatment tool which passes through the endoscope; or a treatment tool which is inserted into the abdominal cavity through another opening formed in the stomach, or which is inserted from the anus into the abdominal cavity through an opening formed in the lower digestive tract. When the manual procedures within the abdominal cavity are completed, the treatment tool for an endoscope is removed; and the opening is closed. When closing the opening, the organs around the opening are drawn together and closed such that the organs are bound together by an O-ring.
-
ES 2 051 241 A1 -
US 6 443 156 B1 discloses a separable double lumen endotracheal tube having a first lumen and a second lumen which are removably affixed together. Either lumen of the double lumen endotracheal tube can function alone for positive pressure ventilation. - An endotracheal tube according to
claim 1 is provided. -
-
FIG. 1 shows a view showing an endotracheal tube of an example useful for understanding the invention. -
FIG. 2 shows a cross-sectional view taken along line II-II ofFIG. 1 . -
FIG. 3 shows a cross-sectional view of the endotracheal tube.FIG. 4 shows an explanatory view of when the endotracheal tube is installed into a patient. -
FIG. 5 shows an explanatory view of when the endotracheal tube is installed into a patient. -
FIG. 6 shows a view showing an endotracheal tube of a first embodiment. -
FIG. 7 shows a cross-sectional view taken along line VII-VII ofFIG. 6 . -
FIG. 8 shows a cross-sectional view taken along line VIII-VIII ofFIG. 6 . -
FIG. 9 shows a view showing an endotracheal tube of a second embodiment.FIG. 10 shows a cross-sectional view taken along line X-X ofFIG. 9 . -
FIG. 11 shows a cross-sectional view taken along line XI-XI ofFIG. 9 . -
FIG. 12 shows a cross-sectional view taken along line XII-XII ofFIG. 9 . -
FIG. 13 shows a view showing an endotracheal tube of a third embodiment. -
FIG. 14 shows a cross-sectional view taken along line XIV-XIV ofFIG. 13 . -
FIG. 15 shows an explanatory view of the endotracheal tube. -
FIG. 16 shows an explanatory view when the endotracheal tube is installed into a patient. -
FIG. 17 shows an explanatory view when the endotracheal tube is installed into a patient. -
FIG. 18 shows an exploded view of an apparatus of an example useful for understanding the invention which is to be used for medical procedure s through a natural opening. -
FIG. 19 shows a cross-sectional view taken along line IXX-IXX ofFIG. 18 . -
FIG. 20 shows an assembled status of the apparatus to be used for a medical procedure through a natural opening. -
FIG. 21 shows a cross-sectional view taken along line XXI-XXI ofFIG. 20 . -
FIG. 22 shows a cross-sectional view of the apparatus to be used for medical procedures through a natural opening. - A detailed explanation of embodiments and examples useful for understanding the invention will be made in the following.
- Moreover, in the following, the same symbols are applied to the same constituent elements. Furthermore, duplicated explanations will be omitted.
-
FIG. 1 shows an endotracheal tube of an example useful for understanding the invention. This endotracheal tube is used by installing it into a patient through the mouth. In addition, theendotracheal tube 1 is used together with an over-tube 2 (one example of a device having an insertion section to be inserted into a body of the patient) which is used for guiding an endoscope through the mouth, and is used by being installed into the patient. Moreover, there is also a case in which thisendotracheal tube 1 is used together with the endoscope (one example of another device) which is used through the mouth, instead of using the over-tube 2; and theendotracheal tube 1 is used by being installed into the patient. - The
endotracheal tube 1 includes a tube main body 3; a connectingportion 4 which is attached to a proximal end of the tube main body 3, and is to be connected to a respirator; and ananchoring portion 5 which anchors theendotracheal tube 1 to a predetermined location in a body of a patient PT. The anchoringportion 5 includes acuff balloon 5a, and acuff tube 5b for supplying air into thecuff balloon 5a. - The tube main body 3 is made from a material such as rubber, which is flexible and is harmless to the human body. Each of a
proximal end 3 A and adistal end 3B of the tube main body 3 has a circular cross-sectional shape. Aflat portion 6 having a flat shape is formed in a middle portion of the tube main body 3. A cross-sectional face of theflat portion 6 explained herein is not limited to a crescent-shape as shown inFIG. 2 , and may be of other cross-sectional shapes such as a rectangular shape, a semi-circular shape, an elliptical shape, or the like. That is, theflat portion 6 may be one having a cross-sectional face which is not a full-circular shape and of which the longer and shorter area axes can be specified. - A portion of the tube main body 3 where the
flat portion 6 is formed, is a portion which is to overlap with the over-tube 2 for guiding the endoscope or with the endoscope to be inserted into the patient PT through the mouth, when theendotracheal tube 1 is installed into the patient PT through the mouth. That is, when viewed from the patient side, the portion of the tube main body 3 where theflat portion 6 is formed, is a portion to be located at a position from thelarynx 7 to the musculus arytenoideus transversus 8. In specifically, theflat portion 6 is formed within a range approximately of 50 mm to 150 mm, from the distal end towards the proximal end side of theendotracheal tube 1. When theendotracheal tube 1 is installed into the patient PT through the mouth and the endoscope or theover-tube 2 is further installed into the patient PT through the mouth, in a portion formed in a flat shape of the endotracheal tube 1 (i.e., the flat portion 6), anouter surface portion 6a of theflat portion 6, formed along the length in the cross-sectional face will contact the endoscope or theover-tube 2 as shown inFIG. 2 . A cross-sectional area of theflat portion 6 is set to be substantially equal to a cross-sectional area of a circular cross-sectional portion formed on the side of the proximal end portion or the distal end portion of theendotracheal tube 1. Furthermore, an external diameter (also an internal diameter) of theflat portion 6 is set to be smaller than an external diameter (an internal diameter) of theproximal end 3A or thedistal end 3B. - Next, a procedure of the example will be explained. In the following, as one example of a medical procedure, an explanation will be given for a manual procedure in which the endoscope 1 (a device for performing medical procedures) is inserted through the mouth of the patient PT, and a desired procedure is performed in the abdominal cavity through an opening formed in the stomach wall. The medical procedure may be one of a variety of procedures such as suturing, observation, incision, inoculation of cells, extraction of internal organs, anastomosis between the lumen internal organs, and the like.
- Firstly, the patient is anesthetized.
- Next, as shown in
FIG 4 , the head of the patient PT is directed downwards and is fixed such that each of thetrachea 9 and anesophagus 10 becomes substantially straight. By this, a passage from thelarynx 7 to the musculus arytenoideus transversus 8 of the patient PT can be made substantially linear; and furthermore, an interference portion between the over-tube 2 to be installed later and theendotracheal tube 1 can be shortened. - Next, as shown in
FIG. 4 , theendotracheal tube 1 is inserted through theoral cavity 12 of the patient PT using a laryngoscope 11. When the distal end of theendotracheal tube 1 reaches a predetermined length on the lung side from the cricoid cartilage, theendotracheal tube 1 is anchored by the anchoringmember 5. That is, theendotracheal tube 1 is anchored by supplying air into the cuff balloons 5a through thecuff tube 5b and thereby expanding the cuff balloons 5a. At this time, theflat portion 6 of theendotracheal tube 1 is located within a region between thelarynx 7 and the musculus arytenoideus transversus 8 of the patient PT. Next, the connectingportion 4 of the anchoredendotracheal tube 1 is connected to the respirator; thereby, supplying necessary air, oxidant gas, or anesthesia gas into the lungs of the patient PT, and artificially controlling the breathing of the patient PT. - Next, as shown as a dotted line in
FIG 5 , the distal end of the over-tube 2 (a device used for performing medical procedures the same as the endoscope) is inserted through theoral cavity 12 of the patient PT until the distal end thereof reaches the inside of theesophagus 10. At this time, the endoscope is used together, so as to be inserted into the body through the inside of the over-tube. - At this time, the
endotracheal tube 1 anchored in advance and theover-tube 2 to be newly inserted will interfere within a region between thelarynx 7 and the musculus arytenoideus transversus 8 of the patient PT; however, theendotracheal tube 1 is provided with theflat portion 6, and theouter surface 6a of theflat portion 6 along the length contacts theover-tube 2. In addition, the shorter diameter of theflat portion 6 is set to be smaller than the external diameter of theproximal end portion 3A or thedistal end portion 3B. Therefore, as shown inFIG. 2 , the width L of an overlapped portion between theflat portion 6 of theendotracheal tube 1 and the over-tube (or an inserting device such as an endoscope) can be comparatively smaller (i.e., the width of a portion overlapped with an inserting device can be smaller compared to the case in which a substantially circular-shaped endotracheal tube having noflat portion 6 is used). As a result, the burden on thelarynx 7 of the patient PT can be decreased. At this time, since the cross-sectional area of theflat portion 6 is set to be substantially equal to that of a circular cross-sectional portion at the distal end portion or the proximal end portion of the endotracheal tube, there is no possibility of causing a problem in which the air-supply amount through the endotracheal tube is decreased by the formedflat portion 6. - Moreover, in the case in which a conventional endotracheal tube having a circular cross-sectional face from the proximal end to the distal end is used, the endotracheal tube and the over-tube, each having a circular-cross section, will be overlapped with each other within a range from the
larynx 7 to the musculus arytenoideus transversus 8 of the patient PT (i.e., a portion where the digestive organ system and the respiratory organ system intersect each other); thereby, greatly increasing the width of the overlapped portion. Thus, the burden on the larynx of the patient greatly increases. When the distal end of the endoscope reaches the stomach, gas is supplied into the stomach using a channel in the endoscope; thereby expanding the stomach. Then, the stomach wall is incised by a high-frequency knife inserted in a channel within the endoscope. - Subsequently, an insufflate needle is embedded in the abdomen of the patient PT, and carbonic acid gas or the like is supplied into the abdominal cavity; thereby expanding the abdominal cavity. The reason for expanding the abdominal cavity is to secure space for performing medical procedures in the abdominal cavity. As for a method for expanding the abdominal cavity, carbonic acid gas may be supplied into the abdominal cavity using a channel within the endoscope instead of using the insufflate needle.
- The diaphragm of the patient PT is pressed while in the insufflate condition. Especially, in the case in which the amount of anesthesia is large, natural breathing becomes hard; therefore, breathing of the patient is controlled by using the
endotracheal tube 1. - Subsequently, an insertion portion of the endoscope is advanced into the abdominal cavity through an opening formed by the incision of the stomach wall, while replacing the
over-tube 2 and the endoscope in accordance with necessity; and thereafter, the predetermined procedure is performed in the abdominal cavity using the endoscope. - Moreover, the reason for replacing the
over-tube 2 in accordance with necessity is that the required cleanliness is different between the inside of the stomach and the inside of the abdominal cavity. Furthermore, the reason for replacing the endoscope is, the same as for theover-tube 2, that the required cleanliness is different between the inside of the stomach and the inside of the abdominal cavity; and the most suitable device for the procedure at that time needs to be used. However, in the case in which procedure can be easily performed using the same device, or in the case in which medical procedures are performed in the luminal internal organs without approaching the inside of the abdominal cavity, the devices such as the over-tube or the endoscope may not need to be replaced. - While replacing the
over-tube 2 or the endoscope in this way, there has been a possibility of applying severe burden on the larynx, which is narrow, for the patient PT; however, also in this case, the burden on the patient PT can be decreased since, as mentioned above, the overlapping portion of theendotracheal tube 1 which overlaps with theover-tube 2 is made as theflat portion 6, thereby enabling a reduction in the width L of the overlapping portion between theendotracheal tube 1 and the over-tube. - Furthermore, since breathing control is performed using the
endotracheal tube 1, it is also possible to switch from manual procedure using the endoscope to conventional manual procedure in which the abdominal wall is widely incised, during the procedure, in accordance with necessity. - When the necessary procedure inside the abdominal cavity is completed, the distal end of the endoscope is retracted to the inside of the stomach wall; and the opening portion is sutured by a treatment tool for suturing. A suture is to close a communication between the inside of the lumen internal organs and the inside of the abdominal cavity; and closing a communication between the inside of the luminal Internal organs and the inside of the abdominal cavity using a way such as anastomosis, is also included in the category of suturing.
- Subsequently, the endoscope and the
over-tube 2 are each removed from the patient PT; and furthermore theendotracheal tube 1 is removed from the patient PT when breathing control of the patient becomes unnecessary. - Moreover, in the first example, the
flat portion 6 is formed at a portion at which theendotracheal tube 1 and the over-tube overlap with each other in the larynx of the patient PT; however, as shown inFIG. 3 , a reinforcing member such as arib 6b which suppresses compression in the shorter direction of theflat portion 6 may be provided at substantially the middle portion along the length of an inner surface of theflat portion 6. In this case, collapsing of theflat portion 6 can be suppressed by therib 6b even when theover-tube 2, the larynx, or the like applies an external force for compressing theendotracheal tube 1. Therefore, an internal space inside theflat portion 6 can be secured more reliably even when the endotracheal tube is made of a flexible material. Moreover, a plurality ofribs 6b may be provided. Furthermore, a rod-shaped member such as a wire for suppressing compression in the shorter axis of the flat portion may be provided as a reinforcing member so as to pass through at least the flat portion instead of therib 6b. -
FIG. 6 shows a first embodiment of an endotracheal tube. The same as the above-mentioned first example, thisendotracheal tube 20 is also used by being installed into a patient through the mouth. Thisendotracheal tube 20 has special features in that a portion of a tubemain body 21, overlapping with the endoscope or theover-tube 2 to be inserted into the patient PT through the mouth when it is installed into the patient (i.e., an interfering portion) is formed into a plurality of (two inFIG. 7 ) branchingpassages 22; and the above-mentioned over-tube 2 passes between the branchingpassages 22. Each of these branchingpassages 22 is also formed in a flat shape. As shown inFIG. 7 , the branchingportions 22 formed in the flat shape are formed such that their longitudinal directions M in a cross section are parallel with each other. - In addition, a total cross-sectional area of the pluralities of branching
passages 22 is set to be substantially equal to a cross-sectional area of a circular cross-sectional portion formed on the side of the proximal end portion 2OA or the distal end portion of theendotracheal tube 20. The total width of the branchingportions 22 in the shorter direction which are substantially orthogonal to the longitudinal directions M in a cross section set to be shorter than an external diameter of the endotracheal tube on the distal end side or the proximal end side. - In the case in which this
endotracheal tube 20 is used, as shown inFIG. 7 , the width L of an overlapping portion between theover-tube 2 and the branchingportions 22 of theendotracheal tube 1 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient while securing the necessary amount of air supplied from theendotracheal tube 20. In addition, since a half way portion of a tubemain body 21 is divided into a plurality of branchingpassages 22, compression of tissue around the larynx of the patient can be decreased when inserting the endoscope or the over-tube. At this point, the burden on the larynx of the patient can be further decreased. - Moreover, in
FIG. 6 and FIG. 7 , an explanation is given for an example in which two branchingpassages 22 are formed; however, there is no limitation to this, and the number of the branchingpassages 22 may be equal to or more than three. Furthermore, as same as the first example, a reinforcing member for suppressing compression in the shorter axis of the branchingpassages 22 may be provided. -
FIG. 9 shows an endotracheal tube of a second embodiment. The same as the above-mentioned first example, thisendotracheal tube 30 is also used by being installed into a patient through the mouth. A special feature of thisendotracheal tube 30 is that amouthpiece 31 is attached to a proximal end side thereof. Aninsertion hole 32 for inserting the endoscope or theover-tube 2 is formed at the middle portion of themouthpiece 31. Aspace 33 is formed on the outer side of theinsertion hole 32 of themouthpiece 31. Thespace 33 communicates with a connectingportion 35 provided on afrontal plate portion 34 of themouthpiece 31; and branchingpassages 37 inserted into thebottom plate portion 36 of themouthpiece 31. The total width of the branchingportions 37 in the shorter direction which are substantially orthogonal to the longitudinal directions M in a cross section set to be shorter than an external diameter of the endotracheal tube on the distal end side or the proximal end side. - Moreover, in
FIG. 9 , areference symbol 39 denotes a string for fixing themouthpiece 31 onto the mouth of the patient; and it is brought to the back of the head of the patient and is bound. In thisendotracheal tube 30, branchingpassages 37 of a tubemain body 38 are formed so as to be separated within a region where a tubemain body 31 overlaps with the endoscope or theover-tube 2 to be inserted into the patient PT through the mouth when theendotracheal tube 30 is installed (i.e., an interfering portion). Also in thisendotracheal tube 30, as shown inFIG. 12 , the width L of an overlapping portion between theover-tube 2 and the blanchingportions 37 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply. Also in the present embodiment, the same as the first example, a reinforcing member for suppressing compression in the shorter direction of the branchingpassages 37 may be provided. -
FIG. 13 shows an endotracheal tube of a third embodiment. Thisendotracheal tube 40 is also used by being installed into a patient through a nasal cavity. Thisendotracheal tube 40 has special features in that a portion overlapping with the endoscope or theover-tube 2 to be inserted into the patient through the mouth when it is installed into the patient (i.e., an interfering portion) is formed into a plurality of (two inFIG. 13 ) branchingpassages 42; and the branchingpassages 42 are formed in a semicircular cross-sectional shape of whichflat portions 42a thereof face each other. The point that the endoscope or theover-tube 2 is inserted between these branchingpassages 22 is the same as in the first embodiment and the second embodiment. Also in theendotracheal tube 40, the total cross-sectional area of two branchingpassages 42 is set to be substantially equal to the cross-sectional area of a circular cross-sectional portion on the proximal end side or the distal end side. - The reason for forming the branching
passages 42 into the semi-circular cross-sectional shape is to let them pass through the nose of the patient when installing theendotracheal tube 40 into the patient. That is, a passage of the nasopharynx is formed in a circular cross-sectional shape. In order to easily pass through this portion, the two branchingpassages 42 form a just circular cross-sectional shape when they are combined with each other. - More specifically, as shown in
FIG. 14 , a shape of each branchingpassage 42 is set such that a dimension L2 in the cross-sectional longitudinal direction when the two branchingpassages 42 are combined with each other is larger than a total dimension L1 in the cross-sectional shorter direction. Similarly, the reason for selecting a flat shape instead of a full-circular shape for the cross-sectional shape of the combined two branchingpassages 42, is in consideration of reducing the maximum external diameter of the portion overlapping with theover-tube 2 or the endoscope to be inserted into the patient through the mouth together with the branchingpassages 42. In the present embodiment, the insertion-ability through the nose is secured by setting the dimension L2 slightly larger than the dimension L1. -
FIG 16 is for explaining the state in which theendotracheal tube 40 is installed into the patient PT through the nasal cavity. In order to guide the distal end of theendotracheal tube 40 into thetrachea 9, forceps inserted through theoral cavity 12 may be used in accordance with necessity. Similarly, as shown by a dotted line inFIG. 17 , for example, theover-tube 2 is inserted through the oral cavity of the patient PT after inserting theendotracheal tube 40 through the nose of the patient PT and anchoring it thereto. At this time, as shown inFIG. 15 andFIG. 17 , it is inserted through an opening made between the two branchingpassages 42. - Moreover, it may be arranged such that the
endotracheal tube 40 is made from a predetermined flexible material; and a state in which combining of the two branchingpassages 42 is secured by the elasticity thereof, while no external force is applied. In this case, insertion of the endoscope or theover-tube 2 through the two branchingpassages 42 can be done by opening these branchingpassages 42 using predetermined tools such as forceps. - Also in this
endotracheal tube 40, the width of an overlapping portion between the branchingpassages 42 and theover-tube 2 can be comparatively small; therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply. - Furthermore, according to the
endotracheal tube 40, since it is installed through a nasal cavity, a length of a portion interfering with devices such as the endoscope or the over-tube can be shorter. That is, comparing to the case in which the endotracheal tube is inserted through the mouth, the burden on the patient can be further reduced since a length of the portion overlapping with devices such as the over-tube or the endoscope to be inserted through the mouth can be shorter. Furthermore, there is an advantage in that it is unlikely to be removed while inserting and removing the endoscope or the like since there is no interference in the oral cavity of the patient. -
FIG. 18 shows a tool used for medical procedures through the natural openings according to an example useful for understanding the invention. Thistool 50 is constituted by anendotracheal tube 51 and an over-tube 52. Theendotracheal tube 51 is used by being installed into the patient through the mouth or through the nasal cavity. The over-tube 52 is used by being installed into the patient through the mouth. - An endotracheal-tube
accommodating portion 53 having a non-circular-cross-sectional shape and capable of face-contacting with theendotracheal tube 51 is formed at a portion of the over-tube 52, overlapping with theendotracheal tube 51 installed into the patient while the over-tube 52 is installed into the patient. The endotracheal-tubeaccommodating portion 53 has, when it is seen in a cross-sectional view, a cross-sectional face in which one part of a circle is removed so as to be flattened. A semi-circularcross-sectional portion 54 is formed at a position corresponding to the above-mentioned endotracheal-tubeaccommodating portion 53 of theendotracheal tube 51. The semi-circularcross-sectional portion 54 has a shape corresponding to a removed portion where the above-mentioned endotracheal-tubeaccommodating portion 53 is formed. That is, when aflat portion 53a of the endotracheal-tubeaccommodating portion 53 and aflat portion 54a of the semi-circularcross-sectional portion 54 overlap with each other, a circular cross-sectional shape is formed as shown inFIG. 21 . - Also in the case in which the above-mentioned
tool 50 for medical procedures through the natural openings is used, an overlapping portion between theendotracheal tube 51 and the over-tube 52 can be comparatively small (i.e., the width of the combined endotracheal-tubeaccommodating portion 53 and semi-circularcross-sectional portion 54 can be comparatively small); therefore, as a result, it becomes possible to reduce the burden on the larynx of the patient PT while securing the necessary amount of air-supply. Moreover, combinations of theendotracheal tube 51 and the over-tube 52 are not limited to that disclosed inFIG. 18 and FIG. 19 ; and as shown inFIG. 22 , the endotracheal-tube accommodating section 53 may be formed by agroove 55 which accommodates a part of theendotracheal tube 51. In addition, it may be arranged such that a cross-sectional shape of the over-tube has a different shape only at a portion interfering with the endotracheal tube. Furthermore, it may be arranged such that the entire range from a distal end to a proximal end of the insertion section of the over-tube has a different shape. - While preferred embodiments of the present invention have been explained in the above, it should be understood that the present invention is not limited to the above-mentioned embodiments. For example, for the embodiments, explanations are given for a manual procedure in which desired medical procedures are performed by introducing devices into the abdominal cavity through the opening; however, the hollow organ in which the opening is to be formed is not limited to the stomach, and it may be formed in any internal organs such as the esophagus or the duodenum, which can be approached through the mouth. Furthermore, manual procedure in which medical procedures are performed in the hollow organ without approaching the inside of the abdominal cavity may be included. Additions, omissions, substitutions, and other modifications can be made without departing from the scope of the present invention. The invention is not to be considered as being limited by the foregoing description, and is only limited by the scope of the appended claims.
- According to the present invention, burden on a patient can be decreased since an overlapping portion of an endotracheal tube, where overlaps with a device is made to be a flat shape to reduce the width of the overlapping portion between an endotracheal tube and the device.
Claims (6)
- An endotracheal tube (1) adapted to be installed into a patient so as to be usable together with a device having an insertion section which is inserted into the body, the endotracheal tube (1) comprising:a portion adapted to overlap with the device installed into the patient and being formed as a flat shape; andan outer surface portion (6a) formed along a longitudinal direction (M) of a cross-section of the portion formed in the flat shape and being adapted to contact the device, characterized in thatthe portion includes a plurality of branching passages (22) each of which is formed in a flat shape.
- The endotracheal tube (1) according to claim 1, wherein
a reinforcing member (6b) which suppresses compression in a shorter-length direction of the cross-section of the flat shape is provided at at least the portion formed in the flat shape. - The endotracheal tube (1) according to claim 1, wherein:the endotracheal tube (1) is adapted to be installed into the patient through a mouth;a mouthpiece (31) is provided on a proximal end side;an insertion hole (32) for inserting the device is formed in the mouthpiece (31); andthe branching passages (22) are each attached to left-and-right sides of the insertion hole (32) so as to extend towards a distal-end side.
- The endotracheal tube (1) according to claim 1, wherein:the endotracheal tube (1) is adapted to be installed into the patient through a nasal cavity;the portion (6a) includes two branching passages (22); andeach of the branching passages (22) is formed so as to have a semicircular cross-sectional shape in which flat portions (6) thereof face each other.
- The endotracheal tube (1) according to claim 4, wherein:the branching passages (22) are made of a material having elasticity; andthe flat portions (6) contact each other due to the elasticity thereof, while an external force is not applied.
- The endotracheal tube (1) according to claim 1, wherein
a cuff balloon (5a) is provided at a distal end thereof.
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PCT/JP2007/050635 WO2007081050A1 (en) | 2006-01-13 | 2007-01-11 | Endotracheal tube and device for use in medical procedure through natural opening |
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US5620408A (en) * | 1995-04-14 | 1997-04-15 | Vennes; Jack A. | Endoscopic over-tube |
GB9718534D0 (en) * | 1997-09-01 | 1997-11-05 | Palazzo Mark G A | Tubular structures |
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US7134431B2 (en) * | 2003-09-08 | 2006-11-14 | Indian Ocean Medical Inc. | Laryngeal mask airway device with position controlling tab |
US7013899B2 (en) * | 2004-08-13 | 2006-03-21 | Engineered Medical System, Inc. | Perilaryngeal oral airway with multi-lumen esophogeal-obturator |
US7921847B2 (en) * | 2005-07-25 | 2011-04-12 | Intubix, Llc | Device and method for placing within a patient an enteral tube after endotracheal intubation |
-
2006
- 2006-01-13 US US11/331,977 patent/US7735489B2/en active Active
-
2007
- 2007-01-11 TW TW096101055A patent/TWI395569B/en not_active IP Right Cessation
- 2007-01-11 JP JP2008532254A patent/JP4981054B2/en not_active Expired - Fee Related
- 2007-01-11 EP EP07706942.5A patent/EP1971384B1/en not_active Not-in-force
- 2007-01-11 WO PCT/JP2007/050635 patent/WO2007081050A1/en active Application Filing
-
2012
- 2012-03-05 JP JP2012048595A patent/JP5498522B2/en not_active Expired - Fee Related
Also Published As
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EP1971384A4 (en) | 2013-12-18 |
TW200738207A (en) | 2007-10-16 |
US20070163596A1 (en) | 2007-07-19 |
US7735489B2 (en) | 2010-06-15 |
JP5498522B2 (en) | 2014-05-21 |
JP2012130762A (en) | 2012-07-12 |
JP2009523031A (en) | 2009-06-18 |
EP1971384A1 (en) | 2008-09-24 |
WO2007081050A1 (en) | 2007-07-19 |
TWI395569B (en) | 2013-05-11 |
JP4981054B2 (en) | 2012-07-18 |
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